title: Very high fluence collagen cross-linking as a refractive enhancement of a regressed previous astigmatic keratotomy.
abstract: OBJECTIVE
  To report a novel application of collagen cross-linking (CXL) in refractive astigmatic enhancement of previously performed astigmatic keratotomy.
  
  
  METHODS
  A 28-year-old woman with prior history of bioptics correction of high myopic astigmatism with femtosecond laser-assisted astigmatic keratotomy followed by topography-guided LASIK showed long-term regression of the astigmatism 4 years later. A novel CXL application was employed in an attempt to reverse the regression of the astigmatic keratotomy.
  
  
  RESULTS
  The high fluence CXL intervention resulted in correction of 2 diopters of topographic and refractive cylinder. Uncorrected distance visual acuity changed from 20/50 to 20/20 and refraction from -0.50 -2.00 @ 90 to +0.25 -0.25 @ 90 at the 7-month follow-up.
  
  
  CONCLUSIONS
  A possible novel application of high fluence CXL with refractive cornea effect is introduced. It may offer rapid and simple rehabilitation and its effect may be tapered.
authors.affiliation: Laservision.gr Institute, Athens, Greece. ajk@brilliantvision.com
authors.forename: Anastasios John
authors.initials: AJ
authors.lastname: Kanellopoulos
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000188:drug therapy / Q000378:metabolism / Q000601:surgery / Q000628:therapy*; D003094:Collagen / Q000378:metabolism*; D003319:Corneal Stroma / Q000378:metabolism*; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D007646:Keratotomy, Radial; D047728:Myopia, Degenerative / Q000601:surgery*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D012029:Refraction, Ocular / Q000502:physiology; D012086:Reoperation; D012256:Riboflavin / Q000627:therapeutic use; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin